Pandemic Fug or Hormonal Horror Show?


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As I write to you, I am sitting in my kitchen looking at a cupboard with half its front missing. My house is old and often in various states of disrepair, but this time I cannot blame deteriorating wood or century-old fittings. The truth is, during one despairing moment of lockdown I took my rage out on the cupboard. Weeks of pent-up frustration, trying to homeschool, work, co-parent, even think straight in a global landscape that was totally unrecognisable, all in intense isolation, brimmed over, and the cupboard got it. And now it sits there, gloating, a reminder of just how provoking a combination of extraordinary and stressful circumstances can be. 

But another factor caused the cupboard to get in the neck. In the last two years, amidst a range of shifting hormones, I have found myself experiencing feelings of rage I never thought possible. It is a surge I can feel coming on, almost like being given a shot of adrenalin, and then sent on your way to try and function normally, when really you are just souped-up drugs. It is hateful, at times frightening, and can be really distressing. The combination of perimenopausal shifts and a pandemic has been an extremely heady one, producing intense emotions and or at times total fug; just a clamber of thoughts that resist any kind of clarity. 

What this perfect storm has done has caused me to look into it further, just even for reassurance that this isn’t the beginning of full-on insanity. What it has led me to is the work of Lisa Mosconi, a neuroscientist and author of The XX Brain. Mosconi has studied brains for over 20 years and is director of the Women's Brain Initiative, and part of her research has unearthed some really amazing truths about how women’s brains function during menopause. But even just leaving mid-life hormonal changes aside, Mosconi points out that women, in general, are more likely to be diagnosed with anxiety disorder, depression, headaches and migraines, and more likely to get Alzheimers. And this really warrants much more attention. 

I realise that this is taking a dark turn, but bear with me. The interaction between our reproductive organs and our brain function is constant throughout our life, Mosconi has found, something that is very distinctive from men for instance. Women’s brains, she has also discovered, age differently, and menopause is a key moment in that process. All the symptoms of hot flashes, night sweats, memory loss, depression, anxiety, these things don’t start in the ovaries, but in the brain. 

Our brains and ovaries are part of the neuroendocrine system, and the health of our ovaries are inextricably linked to the health of the brain. Oestrogen in particularly is directly related to energy production in the brain, it literally pushes the neurons to burn glucose to create energy.

So that fug you experience at certain points in the month, or just more frequently now in midlife? That is caused by something very particular happening on a cellular level. For some women, going through menopause can result in a 30 percent drop in brain energy. 

Okay, this is not perhaps the news we all want to hear. But the truth is, so many of us can feel it. We can feel our minds being influenced, even dominated, by our changing hormones. As Mosconi says, “Women feel like their minds are playing tricks on them, to put it mildly. If this is you,” she says, “you are not crazy.” Also, before you start thinking that women are somehow then also inhibited cognitively because of this flux, the facts are quite the opposite. Menopausal women may be tired, but all research shows that they are just as sharp as their male counterparts.

What it does highlight though is the need for all of us as women in midlife to really look at our brain health and how we can maintain it. For while HRT and other hormonal treatments can manage the symptoms, according to Mosconi, they don’t tackle the root cause. The foods we eat, how much sleep we get, how much exercise and even how much stress is in our lives, they impact our hormones. The Mediterranean diet, for instance, it has been proven, supports women’s health in particular. This, it has been discovered, is because their diet, in particular, is rich in oestrogens from plants. And before you start thinking this all sounds very unsexy, this also includes dark chocolate. What it means is that there is less cognitive decline in general in Mediterranean women, but even things like hot flashes are less prevalent. 

But Mosconi equally states that we also have to be careful about the things that suppress our oestrogen. Stress can literally steal our oestrogen, she says, with an increase in cortisone suppressing its production. And it also works vice versa. This has obviously big ramifications at this time and how we all manage all the current demands, responsibilities, general lack of joy and access to normal stress relievers that we would have relied on pre-Covid. 

But most of all it has completely awoken me to the realisation that women’s health is brain health, and so it is complex, fluctuating and multifaceted, but it is the key to a happy mid, and also later, life. 

Jessie Collins, October 2020.

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